A balanced four-year budget: Bradford Council Executive s Budget and Council Tax Proposals for 2017/ /21

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1 A balanced four-year budget: Bradford Council Executive s Budget and Council Tax Proposals for 2017/ /21 For consideration at the meeting of the Executive on 6 December

2 1 Introduction: financial context 1.1 Bradford Council has had to find more than 250m in savings and increased income over the past six years due to imposed funding cuts from central government, rising demand for services and increasing costs. 1.2 Between now and 2020 we are forced to find another 82m of savings and extra income to balance the books; this is on top of pre-agreed savings of 24m and further increases in Council Tax. This is against the backdrop of the cuts already implemented since the government began its austerity policy in Bradford Council s net budget in 2020 will be around half what it was in 2010 in real terms, accounting for inflation and the growing demand for services. 1.4 Having already managed 250m in savings and additional income since 2010, we have faced extremely difficult decisions in our challenge to close Bradford s 82m funding gap over the next four years. Any organisation no matter how efficient or innovative would face a major challenge in managing a 50% cut to its spending power. Local residents, staff and partner organisations will inevitably feel the impact as the government s policy to cut local authority funding significantly reduces services. 1.5 We must not let the cuts dim our ambitions for the Bradford District. In the proposals we have set out our detailed choices for the next two years and our broader plan for the subsequent period to 2020 to close the significant funding gap while achieving the best possible outcomes. 1.6 The graph below illustrates the gap we are faced with if we fail to act: 500 Forecast Resources 450 m Resources Required Resources Available Council Tax effect / / / / /21 2 The impact of the austerity policy on Bradford District 2.1 Bradford has shouldered a disproportionate share of the Government s austerity policy. Funding decisions which favour less deprived areas are resulting in a postcode lottery around the country. In last year s budget proposals we cited the government s own figures which showed Bradford s spending power had reduced by twice the national average, while Wokingham, the country s least deprived authority, had actually seen an increase. 2.2 Recent research published by the IFS on 28 November 2016 also suggests there have been very different levels of cuts in different part of the country between 2009/10 and 2016/17. According 2

3 to the IFS, Bradford Council has had to cut its spending on services by 33%, whereas Surrey and Hampshire, for example, have each made cuts of just 1%. The IFS figures have been adjusted to remove spending in new areas or changing responsibilities and as a result exclude cuts to funding streams such as Public Health grant, which masks the full picture. 2.3 As government policy places an increasing emphasis on council tax and business rates income for funding local services, there is a risk that areas like Bradford with fewer high-value properties and relatively lower business rates face an ever growing challenge to close the gap with wealthier areas. 2.4 In his autumn statement on 23 November 2016, the Chancellor confirmed the government has withdrawn its pledge to achieve a surplus in the economy by He also said that new investment, not just cuts, is necessary to unlock economic growth. We welcome the new approach to invest in infrastructure. This Executive will continue to push for a fair allocation for the Bradford District of infrastructure investments and we are willing to work constructively with the government and neighbouring authorities to achieve it. 2.5 Bradford is not unique in facing spending cuts. Statistics suggest that since 2010 the UK s local government workforce has been cut by around 25%. The central government workforce has increased by almost 4% in the same period (ONS June 2016). Many parts of the country have lost libraries, theatres, museums, leisure centres, children s centres and community centres; and seen reductions in many other services. In Bradford District we have successfully maintained important services and worked hard to minimise the impact on residents, visitors and partner organisations. But the decisions are increasingly difficult. 3 We are focused on outcomes 3.1 We must maintain a pinpoint focus on our priorities while our funding reductions continue. From the outset in this budgeting process, we have refused to simply sit back and preside over departmental and service reductions. Instead, we have worked with officers to identify the district s absolute priorities and the activities which have the greatest impact for local people. Instead of simply reducing existing services, officers have been tasked with looking afresh at our activities right across the board and ensuring every penny spent has the greatest possible effect on the key priorities we have outlined in our Council Plan: - Better skills, more good jobs and a growing economy - Decent homes that people can afford to live in - A great start and good schools for all our children - Better health, better lives - Safe, clean and active communities - A well-run council. 3.2 The reality of the budgeting process means that, as with previous years, we have had to take decisions we would not otherwise wish to take; we have been faced time and again with competing choices each with a compelling cause. 3.3 However, we want to assure local people that we will continue to fight for a fairer deal for this district and not simply accept ongoing cuts. We are making every effort to ensure our voice is heard nationally and we will continue to make rigorous representations for the proper investment our district needs to help unlock its huge potential and ensure local people get a fair share of any future national economic growth. 3

4 4 Inclusive growth 4.1 The current government has, encouragingly, spoken about inclusive growth. We remain hopeful that the government s policies will match the rhetoric and that they will work constructively with us to ensure people in Bradford District don t miss out on future opportunities. We will continue to make the case for major infrastructure investments in our district. 4.2 We are committed to helping ensure that individual rights are protected and respected regardless of age, disability, sex, gender, race, religion or sexual orientation. That commitment underpins everything we do and in putting forward each of the proposals we have considered the potential impact on all protected characteristics. The equality impact assessments are included in the published budget documents. 4.3 As well as our commitment to safeguarding individual rights, we are also calling on local people, partner organisations, community groups and businesses to take on greater responsibilities and work with us in achieving our mutual goals for the district. 4.4 We will work with staff and trade unions as we rise to the challenges. We value our staff and wholeheartedly believe that their skills and work ethic must be a fundamental part of the solution as we move forward and evolve into a smaller but still hugely influential organisation in the future. We are grateful to our employees 80% of whom are residents in the district for their impressive work amid the challenging circumstances of austerity and we will continue to do everything we can to mitigate the inevitable impact. 5 Our proposals 5.1 We are determined to focus on what our district can achieve. In spite of the severity of the government cuts, we are making a commitment for the next two years to: - Protect the youth service we are the youngest city in the country - Keep all four of our museums open - Keep all seven of our children s centre clusters open - Ensure continuing libraries provision 5.2 However we will not be able to retain all of the above services in their current form all the way to 2020 given the gap arising from more government cuts and rising demand and costs. We will have no option but to look at how these services and others outside our statutory role can be remodelled in order to ensure continuing provision for local people. 5.3 This means that beyond the detailed proposals we have set out for the next two years, nothing can be taken for granted. There is the very real risk that services will have to cease if we are unable to find new ways of retaining them at a reduced cost, such as through alternative models of delivery or greater community or volunteer involvement. 5.4 Our proposed savings for the next two years include: - Taking 8m a year out of Adult social care as part of a transformation of the service - Closing all public toilets except the facilities next to the mirror pool at City Park for children s changing - Transferring all 7 community halls via asset transfer to communities, failing that they will close - Withdrawing funding for Jamie s Ministry of Food 4

5 - Withdrawing from the direct management and maintenance of sports pitches and bowling greens - Reducing clean teams and mechanical sweepers - Deleting the post of Deputy Lord Mayor - Cutting 20% of the events and festivals budget - Introducing limited street lighting hours for non principal roads - Further reducing the libraries budget with increasing reliance on volunteers - Cutting 416 jobs on top of more than 2,000 jobs we ve had to cut over the last five years - Reduce economic development funding, but target it for greatest impact 6 Council tax 6.1 We feel we have little choice but to raise council tax by 1.99% and implement the social care levy by the government s stated maximum of 2% for each of the next two years. In 2017/18 this 3.99% increase amounts to an additional cost of 2.66 a month for a Band A council tax payer and 7.97 a month for a Band H payer. In 2018/19, it amounts to an additional monthly increase of 2.76 in Band A and 8.28 in Band H. 6.2 If we did not raise council tax in this way, even more services would be lost as we would be forced to find another estimated 27 million over four years. 6.3 Our council tax is currently the lowest in West Yorkshire. Nevertheless we don t take the decision lightly and we recognise the additional burden on local people at a time of economic hardship. 6.4 The government s policy for addressing the funding gap in local services is for people to pay more council tax with an expectation that councils will implement the social care precept. The effect of the government s approach is that nationally people are paying more council tax while seeing local services continue to reduce, especially in less wealthy areas with fewer high value properties, as the council tax income falls well short of filling the shortfall. 7 Social care 7.1 There is a national funding crisis around adult social care. Local authorities from across the political spectrum, health professionals, charities and many others raised concerns when the chancellor did not mention social care in his autumn statement. We have argued that having a proper plan for social care will improve people s lives and ease pressures on the NHS. 7.2 There is a growing national consensus that the social care precept falls considerably short of solving the social care funding crisis as demand rises with a growing elderly population. In the next two years, the social care precept will bring in an additional 6.6m, which is unlikely to meet the increased cost of the national living wage. 7.3 Nevertheless we are committed to rising to the challenge in spite of our shrinking resources. We are committed to ensuring that the most vulnerable people in our society get the best possible care. We are committed to ensuring that the local authority does not simply become a subdivision of the NHS. We must continue to ensure people get the universal services they rightly expect. We are proposing a radical adult services transformation plan which we accept is a major challenge and aims to save 8m every year to

6 7.4 The 8m annual saving is in addition to the pre-agreed 2017/18 savings of 10.2m in adult services which will also have to be delivered. 7.5 We will focus our investment on frontline social work. We will increase the level of preventative support for people, with a focus on supporting them in what they can do rather than what they can t do. Earlier and better interventions help people to stay independent and in their own homes for longer and reduce the need for more intensive and costly interventions. 7.6 We want people to be empowered to live fulfilled and independent lives for as long as possible. Supporting people to stay independent also costs the state less money and saves valuable resources for our NHS partners. 7.7 We will offer people more choice and control in their own lives so they have a greater say in the support they receive. We will work closer than ever with health partners with the aim of integrating systems and sharing resources more effectively. 8 The impact on low income groups 8.1 We understand that increases in council tax and charges are an additional burden on local people, in particular those with the lowest incomes. We do not take these decisions lightly and we have considered this impact in making the proposals. 8.2 The best way of supporting people out of poverty is through employment and we recognise that the cuts may impact on our efforts to achieve this. However in mitigation we are continuing to invest in skills programmes aimed towards hard to reach groups which, although a non-statutory service, have a strong track record of helping people into work. We are also committed to working with schools, the voluntary sector, communities and businesses so we have a shared commitment to helping people on the education and employment ladder. 8.3 Depending on their circumstances people on low incomes will continue to have access to various services aimed at easing the burden. These include passport to leisure, housing benefit, discretionary housing payments, council tax reductions and our equity home loans scheme. The Council also continues to support the Bradford District Credit Union. 8.4 We will continue to look at all options for mitigating the impact of austerity cuts on our lowest earning residents. 9 The impact on the voluntary sector 9.1 We work in partnership with the voluntary and community sector (VCS) and we value that partnership which benefits local people. We want to continue working closely with the VCS in future as together we evolve to meet the restrictions of our funding. We want to work with the sector to support its transformation so that its value can be sustained. 9.2 Given our close links and many shared goals, the cut in funding from central government will inevitably also be felt by the VCS. We have considered this impact in making these proposals and we are committed to doing all we can to mitigate it. With shrinking resources and as part of our budgeting process which is focused on outcomes, we have had to review all the activities we fund to date and assess the scale of their impact and value for money. 9.3 We are committed to hearing the views of the VCS on these proposals during the consultation process, including in dedicated events, and we will continue to work closely with the VCS to achieve the best outcomes for the district. 6

7 10 Looking to the future: the cuts must not dim our ambitions for the Bradford District 10.1 We want to be honest about the challenges the district faces but we don t want people to be overwhelmed. We want to work with government, with the NHS, with the voluntary sector, businesses and residents to make sure we build a better Bradford District together The government has said it wants to be inclusive. We wanted the autumn statement to give a strong indication that it was going to match those words with action. We still have hope that the government s commitment to fund infrastructure will come to pass. Our district, with 530,000 people, needs to be off the branch line and on the Northern Powerhouse Rail line. Bradford must not be left behind On education the government is cutting the 7m Education Services Grant and increasingly resources are going direct to academies and free schools. However education remains our top priority. We have 102,000 children in school. Wherever our children are being educated, whether it be in a maintained school, academy or free school, we want to make sure they get the best education. We want to work with government to get the best for our young people. For the North to see an increase in productivity, the children of Bradford District need to be successful; they are the workforce of the future Bradford is a big, powerful city. We are bigger than Liverpool, Newcastle and Bristol. We have the youngest population in the UK. Nearly 25% of our population are under the age of 16. We have strong global links with 85% of our businesses trading internationally. That puts us in a strong position for a post Brexit world and we must capitalise on that strength To reach our potential the council cannot achieve this alone. The government cuts are drastically reducing the size of local government. So we are calling on our communities, public sector partners, businesses, the voluntary sector, faith groups, schools and residents to join with us in creating a better Bradford District. We will not let our challenges dim our ambitions. Such great ambitions can only be realised by us all working together. 11 Have your say: we will listen to your views 11.1 We want local people and organisations to have their say on these proposals. We are committed to considering all feedback we receive throughout the consultation period. We welcome all views on the proposals and the equality impacts. We have a track record of listening The consultation period started when the proposals were published last week and it will run until 12 February Where possible people are encouraged to submit their views via the online questionnaire on the dedicated budget consultation pages on our website where the proposals are outlined in full. Click on the banner on the homepage or go to Alternatively people are welcome to submit their views to the freepost address: Freepost RTLC-KEGA-JGRX, Bradford Council, Budget Consultation, Britannia House, Hall Ings, Bradford, BD1 1HX We will also be publicising the consultation on our social media and digital channels We will be holding a series of meetings with Communities of Interest to discuss the proposals and allow for feedback and ensure the voices of specific groups are heard. 7

8 APPENDIX C - DETAILED BUDGET CHANGES PROPOSED FOR 2017/ /19 & SUBJECT TO CONSULTATION Better Health, Better Lives Total Savings Proposed m m 11.1m Health and Wellbeing - Public Health Ref - 4PH2 Public Health - Substance Misuse transitional funding 10.9m 1,169,000 1,634,000 2,803,000 26% The Substance Misuse service provides a number of recovery-focussed services in the prevention, reduction and treatment of drug and alcohol misuse and its associated harms for individuals, families and communities. The service is currently provided for 4500 individuals in various locations across the district. The budget for substance misuse services will be reduced through a combination of redesign and re-commissioning of services and services ceasing. The Substance Misuse Recovery Service is the new integrated drug and alcohol service currently out to tender, through which individuals receive a continuum of preventive measures, treatment interventions and recovery options. The review of the service will achieve savings in of 1.088m and 1.076m in The Substance Misuse Dual Diagnosis Service provides a specialist Dual Diagnosis from premises in both Bradford and Keighley, delivered by a team of specialist health care professionals. Over 4 years, patients will be gradually transferred to, and managed by, mainstream NHS Mental Health services and/or substance misuse services. This service will reduce in resulting in a saving of 487,000. The Supervised Medication Programme is delivered by 130 pharmacies across the district. The programme ensures that individuals in drug treatment are supervised in consumption of substitution medication within pharmacies and a reduction in demand for this service will lead to an annual saving of 56,000 in and 6,000 in Inpatient Detoxification services are provided by a number of contracted organisations on an approved provider basis outside of the district and provide detoxification in a residential setting. There is little evidence of continued abstinence following discharge, and detoxification can be delivered within the community under the new recovery service and therefore by this service will reduce resulting in an annual saving of 35,000. The Needle Exchange programme offers an open-access service to any drug injector because every person engaged in this activity is at risk of contracting a life- 8

9 threatening blood-borne virus, particularly HIV, Hepatitis B and Hepatitis C. The service is being reviewed to identify cost effectiveness and ensure geographical coverage of service. It is anticipated that a new delivery model and this redesign will lead to an annual saving of 25,000 in and 30,000 in Impact assessments have identified that this range of proposals could have impacts on a wide range of service users across the range of protected characteristics. Any new contracts will continue to have the same equality requirements of the Provider under the Equality Act 2010 as the current tender. The new service specification being commissioned requires that the service is provided through various types of provision and that the service is integrated throughout providing continuity for service users. Services will be more community based with access points in multiple sites in non-substance misuse specific services making it easier for all sections of society to access them. See EIA 4PH2 Ref - 4PH3 Public Health - Sexual Health transitional funding 4.7m 70,500 25,000 95,500 2% The Sexual Health service provides open access to Bradford residents to all forms of Contraception, Sexually Transmitted Infection testing and treatment, information and support, allowing easy access to services by giving them the choice of either an appointment or access to drop-in clinics across the district. The budget for the service will be reduced through a combination of redesign and review of services, and other services ceasing. Prism is a service in which a Health Development Worker works with young people, delivering information, advice, support and referral (where appropriate) through 1-1, Drop In and Group Interventions. The proposal is that this service will cease from 31 March 2017 resulting in an annual budget reduction of 55,500. Step2 is a service which supports the delivery of a Sex and Relationship Education (SRE) programme in schools. The SRE programme is delivered in 9 upper schools within the district and is co delivered by a teacher, Step2 or School Nurse in the class room and discusses sexual exploitation, sexuality, and abusive relationships, as well as a range of other topics giving young people information around local services and where they can access support. The proposal is that this service will cease from 31 March 2017 resulting in an annual budget reduction of 15,000. Emergency Hormonal Contraception (EHC) is made available in Pharmacies, free-of-charge, 9

10 to those aged 25 and under. Pharmacists also provide condoms and chlamydia screening giving advice on contraception and sexual health and signposting to Sexual and Reproductive Health Service (SRHS) for further support. The proposal is that this service will cease from 31 March 2018 resulting in an annual budget reduction of 25,000. Some of the services are designed specifically for parts of the population who share a protected characteristic. Therefore services are provided disproportionately to those parts of the population and the impact will reflect this. The financial implications of this reduction in budget will be applied across the whole of the contract and therefore will impact upon all potential users of the services. The SRHS that is commissioned is part of a wider Sexual Health economy with GPs providing oral contraception and STI testing which is commissioned by NHSE from GP practices as part of their core service offer. Bradford residents would still be able to access SHRS (oral contraceptives and STI screening) within their community through their GP practice and Long Acting Reversible Contraceptives (coils and implants) and STI testing and treatment, through the SHRS that would stay situated centrally within the city centre making it accessible to all. See EIA 4PH3 Ref - 4PH4 Public Health - Tobacco transitional funding 0.8m 2,000 59,200 61,200 8% The tobacco service provides and commissions services to reduce smoking prevalence across the district and prevent the uptake of smoking by young people. The budget for the service will be reduced through a combination of the redesign and review of services which will see some currently commissioned services ceasing and a reduction in the number of people accessing services. Dental Practices across Bradford District are currently commissioned to provide a practicebased stop smoking service. As part of the redesign of stop smoking services, dental practices will not continue to be commissioned to provide this service and therefore will cease in April 2017 resulting in an annual budget reduction of 2,000. Stop smoking medication is available on prescription to smokers, through the Bradford district stop smoking service. This will be limited to geographical areas identified as having higher smoking prevalence and priority groups e.g. pregnant smokers, patients with a long term condition etc. This redesign will lead to an annual saving of 44,

11 The Midwifery-based stop smoking service provides a specialist stop smoking midwife to provide and coordinate training, implement and monitor interventions to reduce smoking and promote smoke free homes throughout pregnancy. This service will cease in January 2019 resulting in a budget reduction in 2018/19 of 15,200. Equality assessment carried out indicated that this proposal is likely to have no or a low impact on everyone, and so there is no disproportionate impact on any group who share protected characteristics See EIA 4PH4 Ref - 4PH5 Public Health - Homestart, Worksafe and Injury Minimisation Programme transitional funding 0.2m 190,000 55, , % The services commissioned are for children, young people and their families with a focus on accident prevention, and support for vulnerable parents and children age 0-5 years. The proposal is to phase out the services detailed below over two years, with a view to some activities being mainstreamed into the wider transformation plan for children and young people and families in the District. Homestart Homestart is a national charity with independent schemes in local communities which recruit and train volunteers to help families with young children by visiting them in their homes. The proposed plan is to end the current grant agreement with Homestart in 2016/17. The service would therefore cease resulting in an annual saving of 155,000. Injury Minimisation Programme (IMPs) The Programme is aimed at all year 6 children in all Primary schools and aims to reduce injuries and empower young people to take personal responsibility for managing their own risk. It is proposed that the service will cease in , giving the required 6 months notice from April 2017 (therefore terminating at the end of September 2017), resulting in an annual saving of 70,000, ( 35,000 in each of the two years). Worksafe This Voluntary and Community Sector (VCS) service provides training, advice and information about a range of safety issues to selected primary schools and to children with special needs. It is proposed that this continues for one year and stops in year 2018/19. This service will cease resulting in an annual saving of 20,

12 Impact assessments have identified that this range of proposals could have impacts on a wide range of service users across the range of protected characteristics particularly age, disability, race and low income families. There will be impact on key public health outcomes which are likely to widen inequalities in some of our vulnerable groups as these services are delivered across the areas that have already been identified as a strategic priority within the District s Health Inequalities Action Plan. Some activities may be mainstreamed into the wider transformation plan for children and young people and families in the District going forward but there will be some that will not be mitigated against. In order to manage any negative affects we will use a phased approach so that we can identify any potential risks in the first year. Some risk may be mitigated with funding from other areas within the District through Better Start and Big lottery in Keighley so the negative consequences are not as high as would be expected if the service was completely decommissioned. See EIA 4PH5 Ref - 4PH6 Public Health - Physical Activity, Food and Nutrition transitional funding 2.0m 1,000, ,000,000 51% The Health Improvement Team currently provides grants to 24 VCS organisations which deliver a range of interventions including activities such as cook & eat programmes, physical activity sessions for inactive adults and children, food growing activities and breastfeeding support. These grant agreements come to an end on 31 March 2017 and it is proposed that they will not be extended which will result in an annual saving of 1m. Services are currently commissioned from a variety of BME organisations and groups based in low income areas to ensure positive outcomes for all parts of the community. The race equality impact is judged to be high, because of the high BME take up of VCS services. The Health Improvement Team will support providers/organisations and service users proactively with advice and sign-posting as opportunities are identified. See EIA 4PH6 12

13 Ref - 4PH7 Public Health - Small Grants (Wider Determinants) transitional funding 0.1m 101, , % The Public Health Department funds VCS organisations through the small grants scheme to deliver a range of interventions addressing broader public health outcomes including sexual health, smoking cessation, cancer awareness, teenage pregnancy and healthy lifestyles interventions. These grant agreements come to an end on 31 March 2017 and it is proposed that they will not be extended which will result in an annual saving of 101,000. Equality assessment carried out indicated that this proposal is likely to have no or a low impact on everyone, and so there is no disproportionate impact on any group who share protected characteristics See EIA 4PH7 Ref - 4PH8 Public Health - Warm Homes Healthy People Programme transitional funding 0.08m 25,000 40,000 65,000 76% The Warm Homes Healthy People (WHHP) is a short-term, winter activity based programme which supports those most in need of Winter Warmth services in Bradford and Airedale area. Services offered include food parcels and hampers; cook and eat sessions; big lunches; provision of practical needs such as coats; hats; duvets and emergency heating appliances; small fuel poverty remedies (radiator foils, draft excluders etc), energy efficiency assessments; fuel debt relief; top-ups for prepaid fuel meters and community activity such as snow clearance, befriending schemes etc. The proposal is to reduce this service, resulting in an annual saving of 65,000. (Note: This proposal is exclusive of 30,000 currently received from City and District Clinical Commissioning Groups (CCG s) via the local resilience fund). 13

14 Currently the proposal offers support to a range of vulnerable householders, many of whom share particular protected characteristics. Removing the programme s main funding reduces the breadth of service offered and may disadvantage some people. The current budget includes 30,000 received from City and District s CCG s Resilience fund. This may continue to be available beyond the time when funding via Health and Wellbeing ends. Should the CCG contribution continue it would not be able to support a WHHP programme the size it is now; tighter more specific client targeting would be required. In 2016/17 support to develop a new approach to funding was granted to the partners, this has allowed the creation of a crowd funding website which plans to raise 25k this year. It is planned to build on this in 2017/18 with the hope that core services such as fuel poverty and food poverty work streams can be maintained. Additionally there are existing partners such as Ground Works/ Family Action and others who fund raise for services independently and join in the programme each winter. It is hoped this can be continued. See EIA 4PH8 Ref - 4PH9 Public Health - Back office CCG funding transfer transitional funding 0.5m 0 499, , % The funding is a budget adjustment, transferring funding to Bradford Clinical Commissiong Group s (CCG s); the funding is then paid to provider Bradford District Care Foundation Trust (BDCFT) as part of existing contracts held between CCGs and BDCFT. The funding was, prior to , part of a contract between Public Health and BDCFT. Specific services are not described as part of this funding agreement and known only to CCGs. It is proposed that services are redesigned as part of an accountable care system/organisation development involving health, social care and other providers, resulting in an annual budget reduction of 499,

15 Ref - 4PH10 Public Health - Staffing and operational cost reductions transitional funding 3.4m 300, , ,000 19% The Public Health staff team comprises of the Public Health management team, analysts and commissioning/business unit staff who are responsible for supporting and directing strategic needs assessment for the district and commissioning services directly to meet identified need in responsible areas. In addition, the department employs operational staff to deliver some public health services, specifically sexual health, stop smoking and health improvement (physical activity, anti-obesity). It is proposed that the Public Health staff team is reduced in line with Public Health redirecting its investment profile towards reducing demand and maintaining health and wellbeing. Ref - 4PH11 Public Health - Environmental Health Restructure transitional funding 1.0m 35,000 40,000 75,000 8% It is proposed to undertake a management restructure within the Environmental Health Service as part of wider changes in the Department of Health and Wellbeing. 15

16 Environment and Sport Ref - 4E11 Environment and Sport - Sport and Physical Activity Service transitional funding 2.3m 0 150, ,000 6% Swimming pools, sports centres, swimming development, sports development and outdoor adventure activities form the basis of this service. A number of changes are proposed. In the first instance the service will investigate through an options appraisal all methods of future operational service delivery and this will include the potential for a not for profit trust model to be established as part of the potential savings required in Equality assessment carried out indicated that this proposal is likely to have no or a low impact on everyone, and so there is no disproportionate impact on any group who share protected characteristics See EIA 4E11 Health and Wellbeing Adult and Community Services Ref - 4A1 Adult and Community Services - Overall Demand Management Strategy Total Budget for Service Area 108.4m 8,000,000 8,000,000 16,000,000 15% The latest statistics from Projecting Older People Population Information (POPPI) and Projecting Adult Needs and Service Information (PANSI) projects a 2% yearly increase in the number of service users up to The challenge is to change the culture in Adult Social Care and with the NHS to move from a dependency model to one that promotes independence and resilience (a strength based model, with a focus on what people can do, and positive risk-management so people can live their lives to the full). The Sustainability and Transformation Plan includes development of an Accountable Care System. The aim of this will be to use our investment to improve the health and wellbeing of people in the Bradford District. We will do this by targeting our collective resources to maximise independence and resilience, regardless of age, disability or condition and protecting and safeguarding the most vulnerable in our communities. 16

17 The challenge in Adult Social Care is to deliver services to growing numbers of bother young and older people, whilst at the same time discharging our statutory duties. We will where possible support people to be safe and independent at home and so reduce the need for some people to go into residential/nursing Care. We will do this by working with our NHS and community and voluntary services partners to promote independence through strength based assessments, a greater focus on prevention/early intervention and using enabling technologies. This approach will be underpinned by an integrated workforce development plan which will focus on the Home First Model: 1. Reducing the number of people coming into care through an enhanced preventative focused (early intervention) approach, which will aim to minimise the need for long term support by addressing underlying needs at the earliest stage possible, and reduce the need for some people to go into hospital or a care facility. 2. Changing the culture across the care system: moving to a strength (asset) based model that will require an open dialogue with the people, their families and carers to draw on these resources to maximise independence; and ensuring that people get the right level and type of support i.e. not too little and not too much. 3. Speeding up integration with Health to ensure we can establish a whole systems approach across the Health and Social Care sector and secure efficiencies and economies e.g. Integration of complex care teams with partners within NHS and Voluntary and Community sector, so that service users receive the right care at the time in the right place, and so that support from Health and Social Care is seamless. Ensure all service users are reviewed on a regular basis in line with the guidance set out in the Care Act, so that the appropriate package of care is delivered subject to the individual s needs. 4. Moving away from expensive traditional forms of support through targeted care and enhanced reviews of care needs. This could include options such as extra care or improved home care services and only using residential or nursing care when people really need it. 5. Redesigning our approach to enablement to reduce costs and maintain independence of people e.g. more investment in home care. We will do our utmost to support people to regain skills and confidence to stay independent including use of technology. 6. Reviewing the financial needs of people to ensure that they are provided with the appropriate level of funding to meet their care need. When we assess people we will ensure that they get the right support from either health or social care funders. 7. Continuing the implementation of personalisation including the use of ISF s (Individual Servicer Fund). ISFs are a third party agreement that will ensure that people can have choice and control without the worries of looking after the money. Our approach builds on our local experience and research undertaken by national bodies which has demonstrated that significant amounts can be saved through effective demand management across the support system. The key underlying principle will be to ensure we deliver services in the short term, while using this time to develop the provider market to take on service delivery in the medium and long term. These proposals are designed to enable the costs of the services to be contained within the 17

18 proposed available resources, despite the predicted rise in demand of approximately 2% annually, and inflationary increases in costs affecting Adult Services. This proposal reflects our conclusion that we need to make changes to the way we deliver services in order to avoid annually 8m of costs that would otherwise be incurred. This level of saving is required even after the use of additional income from the Better Care Fund, and from the Social Care precept equivalent to 2% of Council Tax. This is a challenging, yet achievable goal. Older people and people with Mental Health & Learning Disabilities will predominantly be affected by this proposal but the focus will be on personalised services for people so the impact on protected characteristics will be mitigated at individual level. As part of the Strategy to reduce residential and nursing places it is intended that more extra care schemes are developed, which will help to improve people s lives and reduce expenditure across all groups. As the proposal is developed, the detail of impacts will be further assessed to ensure any potential implications on protected characteristics are minimised. Our approach will seek to focus on people s strengths and enabling people to manage properly understood, proportionate and positive risks in living their lives. We will undertake individual assessments and carry out extensive engagement with service users, carers and advocates to ensure seamless transitions for any service users affected. This will enable us to meet our duty under the Care Act 2014 and mitigate against any disproportionate negative impact on any person with a protective characteristic. By offering other options for people in terms of housing and care support, people will have the opportunity to access appropriate services that meet their assessed needs and be in a position to maintain their independence and to continue to have a positive contribution and be inclusive in their local community. This will ensure where possible people with particular characteristics are not disproportionately affected. We will further review the potential impact on protected characteristics as part of the development of the delivery programme. See EIA 4A1 Children s Services - Children s Social Care Ref - 4C4 Child Protection management restructure transitional funding 7.0m 240, , ,000 7% This activity area includes the work of the fourteen teams who work in front line Child Protection in the District, the specialist services management team, and the interpreting budget for children in the care system. The proposal is to undertake a review in year 1 to 18

19 align the Child Protection teams with a revised approach to delivering early help to children and families that includes a range of services to be delivered at a locality level. Currently there are fourteen team leaders in the child protection teams. The proposal is that the number of teams is reduced by four to ten, potentially resulting in a reduction in the number of team managers. This process will be started in year 1 but full savings will not be realised until year 2 due to the requirements for review and consultation. In addition the proposal is to review the overall staffing & non staffing budgets and identify further saving in years 1 and 2 of 2% in each year. Ref - 4C5 Service Wide - Further management savings transitional funding 57m 85,000 85, , % Across Children s Social Care, the role of team managers is to oversee cases and support social workers to put in place good plans for children. They are responsible for an outcome area within specialist services. This proposal is that a review is undertaken of the management structure within children s social care, reducing it by two service manager posts and one team manager in addition to team manager reductions identified in other service areas. Ref - 4C6 Early Help - Review management structure and commissioned services transitional funding 4.7m 80, , ,000 4% 19

20 Within the scope of this activity is early help for children and families commissioned from the VCS, Youth Offending Team, crime prevention and the family centres, families first and other early help services offered through children s centres, and for disabled children and young people The targeted early help portfolio includes a range of statutory, early intervention and prevention services. These seek to help vulnerable families to help themselves, become more resilient and take action early in the life of a problem for children of all ages. Funding comes from a number of sources including the council, Youth Justice Board and Troubled Families Programme. This proposal is to undertake a review of the management structure resulting in the reduction of 1 Team Manager, and a review of the external commissioning budget to achieve a reduction of 15% in year 2. In addition there will an overall review of the service to achieve a 1% budget reduction. This service works with a higher percentage of children and families from disadvantaged households and any reduction in service may result in a disproportionate affect on low income groups needing this support. The review will ensure that resource is most effectively targeted at areas of need, with careful mapping of service needs and outcomes. This process will be done alongside the VCS to ensure that impact is mitigated where possible. Where possible, resources will be reduced in back office and management functions. See EIA 4C6 Ref - 4C7 Looked After Team transitional funding 1.9m 19,000 19,000 38,000 2% Within the scope of this activity is the Looked After Children s team, young peoples advocacy and the Children in Care Council This proposal is to undertake a review of overall staffing & non staffing budget and save 1% each year from within the service. 20

21 Ref - 4C8 Fostering and Adoption management restructure transitional funding 17.9m 0 50,000 50,000 0% Within the scope of this activity is the staffing of fostering service; buildings; marketing; fostering fees; foster care assessments and panels; family and friends carer assessments and allowances; fostering fees and allowances; crisis and carer support costs. The change proposed is to review the team manager structure of the service to remove one post in year 2 making a saving of 50,000. This will be achieved through a review of workload and rationalising the current four teams into three. Ref - 4C9 Disabled Children Team transitional funding 5.2m 250,000 34, ,000 5% Within the scope of this activity is the Children s Complex Health and Disabilities team staffing, placement support, inclusion intensive support, Children and Adolescent Mental Health Service (CAMHS), under 18 drugs and alcohol, short breaks, family intervention, trusted adult, shared care and contract carers. The Children with Disabilities Service is made up of two elements. 3 Residential Units; Clockhouse, Wedgewood and Valley View 3 Statutory Social Work Teams. This proposal is to build on the review already underway with CAMHS to ensure a service that meets the needs of children moving forward and is delivered within a reduced budget saving 250,000. In addition the proposal is to review the overall staffing & non staffing budget and save 34,000 in Year 2. This service works with disabled children who have are a group with a protected characteristic. Reduction in this service impacts on this specific group of young people. 21

22 A review of the CAMHS service with a financial appraisal will ensure that through achieving better value for money, direct service reductions are minimised. The review will ensure that resource is most effectively targeted at areas of need, with careful mapping of service needs and outcomes. Where possible resources will be reduced in back office and management functions. This change impacts on disabled children, but reductions are in place across the full service and have not targeted this group disproportionally. See EIA 4C9 Ref - 4C10 Child Protection Review Team transitional funding 1.2m 0 24,000 24,000 2% The services in scope are the Independent Reviewing Officer and Child Protection Chairs, and the LADO (Local Authority Statutory Officer). These services are all statutory. This proposal is to undertake a review of all staffing & non staffing budgets and achieve a saving of 2% of budget in Year 2. Areas that will be looked at include vacancy management and use of software to reduce administrative requirements. The review will prioritise non staff spending for reduction but there may be a requirement for staff reductions. Ref - 4C11 Leaving Care transitional funding 3.5m 68,000 34, ,000 3% Within the scope of this activity is the staffing of the service, university support, Southwark judgement costs, semi independent placements and stepping stone support. 22

23 This proposal is to review overall staffing & non staffing budgets to achieve a saving of 2% in Year 1 & a further 1% in Year 2. Areas that will be looked at include vacancy management, improved procurement arrangements on items bought for young people, a review of agreements with providers of purchased services and closer monitoring of grants paid to young people to ensure that this is in line with the agreed policy. The review will prioritise non staff spending for reduction but there may be a requirement for staff reductions. Ref - 4C13 Drugs and Alcohol Team Note - This relates to funding linked to a Public Health Inter Departmental Agreement and should be seen as a loss of funding to the Service transitional funding 0.3m 50,000 50, ,000 29% The Alcohol and Drugs Team is a specialist service tasked to address substance misuse as it affects children, young people and young adults who are parents. This proposal includes a review of the work of the team and all of the other services that support young people with alcohol and drug issues to achieve a saving of 50,000 in year 1 and a further 50,000 in year 2. NB - Public Health England announced further cuts in Public Health grant of 1.085m in 2017/18 and a further 1.116m in 2018/19, total reduction over the two years of 2.201m. These reductions in grant will be met by some of the reductions in Public Health services shown above. The total for Better Health, Better Lives savings proposals are reduced by this figure 23